Risky injections

Injections are the most common medical procedures.1 More than 16 billion are given annually in developing and transitional countries, but most of them are unsafe.23 The World Health Organization defines a safe injection as one that does not harm the recipient, the health worker, or the community.2

Each person in the developing world receives an average of 3.7 injections a year.2 Most of these (>90%) are for treatment, while the rest are for preventive purposes such as immunisation and family planning.45 Common unsafe practices include reusing disposable syringes, replacing needles while making use of the same syringe, use of multidose vials, repacking, improper handling of sharp waste in clinics, resale of used injection equipment, and improper sharps waste disposal.267

Allergic reactions and abscesses are the most common side effects of injections.8 They may lead to traumatic lesions such as paralysis secondary to sciatic and radial nerve lesions. Every year the reuse of syringes may cause 20 million infections with hepatitis B, 2 million with hepatitis C, and 250 000 infections with HIV and other blood borne pathogens worldwide.9

The history of hepatitis B virus transmission through use of contaminated syringes dates back to the 1940s, when hepatitis outbreaks were investigated. Those epidemics showed a clear relation between time of disease onset and exposure to reused syringes. Later, in the …